"La investigación sobre la exacerbación de síntomas post-esfuerzo (PESE) respalda esto: una vez que los síntomas se intensifican, no hay una reversión rápida, por lo que la mejor oportunidad de estabilidad es proteger el umbral antes de cruzarlo".
#EncefalomielitisMiálgica
#MEcfs
#EMsfc
#PESE
Key Outcomes & Speakers Understand what energy-limiting conditions are, their key features, and how post-exertional symptom exacerbation (PESE) works in your body. Learn why standard advice often fails and how pacing offers a different approach. Explore practical pacing strategies that protect your baseline and create steadiness. Leave with gentle, actionable next steps you can adapt to your own body's patterns and needs. Meet Our Speakers Abby Kubiak, OTD, OTR/L, LRC Occupational Therapist and Founder of One Life Lived Well I am a licensed occupational therapist passionate about supporting individuals living with Long COVID and other complex and chronic conditions. I’ve been on the frontlines since 2023 as the occupational therapy presence at the Long COVID Recovery Center in Buffalo,
Free webinar:
"Understanding Energy-Limiting Conditions, Pacing, and Post-Exertional Symptom Exacerbation: February 23, 12pm ET"
www.onelifelivedwell.com/products/liv...
Comment: I have been impressed by understanding shown by this OT in her writings
#MEcfs #LongCovid #PESE #CFS #PwME
Crawling around in the loft to find a couple of old boxes. Emptying the ashes box from the fireplace. Cleaning out and disinfecting the cat litter trays. I have a strong suspicion that my 'relaxing' Sunday morning is going return to bite me with a vengeance later.
#LongCovid #PESE #PEM
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“The work has to continue, the messy, mundane, bureaucratic and deeply human work: documenting symptoms, pushing for screening and access, training clinicians in #PESE / #PEM and dysautonomia, funding longitudinal research, and insisting that care be co-designed with the people who will use it”
virology.ws/2026/01/27/t... Thanks to the wonderful David Tuller for sharing this perfect account of what it’s like to have severe ME by Zöe in the UK #ME #MECFS #MedicalGaslighting #PEM #PESE #PENE
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He highlights how post-exertional malaise can lead a worsening of the condition which could be permanent.
# #LongCovid #MEcfs #PostExertionalMalaise #PEM #CFS #PEM #PESE
m.youtube.com/watch?v=uAXJ... Listen & share. Thanks to Emily Kate Stephens for her excellent interview with the great exercise science expert, Todd Davenport, champion of ME & Long Covid patients dealing w/ Post Exertional Neuroimmune Exhaustion #PENE #PEM #PESE #ME #LongCovid #POTS #MakeVisible
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“I understand that movement is often helpful, but in my case, activity tends to cause post-exertional worsening of symptoms. That’s different from deconditioning. Could we explore pacing or energy conservation instead?”
#PwME #LongCovid #PEM #CFS #PESE #PENE
Speaking Your Body’s Truth: Talking to Providers About Post-Exertional Symptom Exacerbation Translating your lived experience into words that help providers understand and support you. Abby Sep 27, 2025 You shouldn’t need a script to be believed. However, if you live with Long COVID, ME/CFS, POTS, or another complex condition, you may already know the reality: sometimes you do. Sometimes you have to walk into an appointment armed with notes, rehearsed lines, and backup support, to make sure your experience gets through the filter of a system that doesn’t yet fully understand you and to help your providers understand your circumstances more deeply so they can make good decisions regarding your care. If you’ve ever written out talking points before a visit, practiced how to sound “reasonable,” worried about striking the right balance between tired but not too tired, or even brought a friend to vouch for your story: none of that is an overreaction. It’s how people learn to navigate a system that was not built for them.
🧵
Speaking Your Body’s Truth: Talking to Providers About Post-Exertional Symptom Exacerbation
onelifelivedwell.substack.com/p/speaking-y...
From a sympathetic and knowledgeable occupational therapist who specialises in ME/CFS and long Covid
#LongCovid #MEcfs #CFS #PwME #POTS #PEM #PESE
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5. In summary, the importance of exploring #PEM #PESE #PENE in CYP with Long Covid is crucial.
In his recent presentation at the @UofTCOVIDRehab, @sunsopeningband.bsky.social said "ignore PEM at our peril"
Learn more about #PESE #PEM from @LC_Physio
youtu.be/6QD0HPOGKic
🔸NEW #CLoCK paper
📍https://bit.ly/47W7tJI
Improving co-production would support the analysis to better consider broader challenges for children & young people with #LongCovid.
#PEM #PESE #PENE
Coproducing research with enough patients, with relevant lived experience is vital in study.
Japanese diary with corrections, with a sketch of a woman in a sheet mask
PESE every 3weeks even I pace carefully, milder nowadays but still,
1-2 days of low grade fever. Dejected usually.... this time I employ the Power of Beauty Ritual!! A facial mask can kill a few hours while resting totally, and yield glowing complexion! #longcovid #sketchbook #sketchdiary #PESE
reverse the long-term debility so many are experiencing.
Until then, we could all use a reminder to stop, rest, and pace. It’s especially hard when there are so many things in this life we’d all like & need to do. #ME/CFS #pwME #LongCOVID #PEM #PESE
@winstonblick.bsky.social
📣 New Podcast! "Meta pierde a tres investigadores de su división de superinteligencia artificial. Dos de ellos volvieron a OpenAI, pese a las ofertas millon" on @Spreaker #a #artificial #de #division #dos #ellos #investigadores #las #meta #millonarias #ofertas #openai #pese #pierde #su #tres
The image shows a health tracking app dashboard with three key metrics at the top: Stress: 97% – labeled "Very high" in red. Energy: 14% – labeled "Shortage" in red. Health: 45% – labeled "Vulnerable" in yellow. Below, there’s a line chart from 14/07 to 10/08 tracking daily scores. The chart uses: Green circles for "Balanced" days, Orange squares for "Unbalanced" days, Red triangles for "Low" days, Gray background band showing the baseline range. The trend starts in the balanced range but gradually declines over time, moving into unbalanced and then low levels near the end of the period.
I'm in a pretty bad "crash" 💔😴
Think it's to do with everything that's going on in my 🫁 . And I had the audacity to do 2 tiny things spread out over 2.5 weeks. I've been in bed all week but HRV just ⬇️🤷♀️
#LongCovid #PwME #PESE #POTS #ChronicMigraine #MCAS
#SouthTyneside people who this might be helpful for,please let me know! I’m still waiting to hear back from #NationalTrust about my proposal. Be great to start this in the Autumn/Winter take up& preparations depending #pwME (mild-moderate) #LongCovid #PEM #PENE #PESE #Connection #SafeSpace #HEPA
#SouthTyneside people who this might be helpful for,please let me know! I’m still waiting to hear back from #NationalTrust about my proposal. Be great to start this in the Autumn/Winter take up& preparations depending #pwME (mild-moderate) #LongCovid #PEM #PENE #PESE #Connection #SafeSpace #HEPA
Educational graphic titled 'Post-Exertional Malaise: Clinical Attributes – Part 2 of 7.' Features Dr. Brayden Yellman and Dr. Lucinda Bateman, both wearing white lab coats and smiling. The Bateman Horne Center logo appears in the bottom left corner, with their names and titles listed: Dr. Lucinda Bateman, MD and Dr. Brayden Yellman, MD.
Informational graphic titled '24–48 Hours Symptom Delay.' Includes a bar chart labeled 'Range of PEM Onset Times' showing that post-exertional malaise (PEM) symptoms can occur immediately after exertion, a few hours later, after 12 hours, at 24 hours, or after 24 hours. Bars indicate both earliest and latest onset reported. A citation below references the source: Chu L et al., PLoS One, 2018.
Educational graphic titled 'PEM = Energy Debt, Scenario 1 – Energy Spending Spree.' Shows a calendar icon marked 'MON' with $1 of available energy. Surrounding it are nine $1 icons, representing energy overspent. A red total at the bottom reads '-$9.00,' illustrating the concept of energy debt that can lead to post-exertional malaise (PEM). The Bateman Horne Center logo appears in the bottom right corner.
Educational graphic titled 'PEM = Energy Debt, Scenario 2 – Energy Debt Accrual.' Shows a bed with an IV pole beside it, symbolizing illness. Surrounding the bed are multiple 25¢ icons, representing small, repeated energy expenditures that accumulate over time. An invoice labeled 'Past Due' with 'Interest Rate Applied' emphasizes the accumulating toll. The Bateman Horne Center logo is in the bottom right corner.
PEM isn’t just fatigue—it’s “energy debt.”
In Ep. 2 of our PEM/PESE Series, Drs. Yellman & Bateman explore triggers, onset, and duration based on Dr. Lily Chu’s study.
Watch: bit.ly/3ZLi9WS
#MECFS #LongCOVID #PEM #PESE #MERC @openmedf.bsky.social
/off topic but this reminds that my iPhone’s face recognition has no problems when I’m wearing a hat, mask AND sunnies; yet with none of those things but in a flare/crash/dysregulation? It repeatedly fails.
Anyone else? 🤔
#Dysautonomia #PEM #PESE #POTS #LongCovid #LongVax
PESE: Post-Exertional Symptom Exacerbation
(Though “Explosion” isn’t wrong either 💥)
One short walk → three-day crash.
Symptoms don’t just return — they throw a reunion party.
#PESE #PEM #LongCovid #MECFS #PacingNotPushing
🫣🙄😊
A cartoon-style illustration shows two versions of the same woman in a living room. On the left, her energetic past self jogs by with a laundry basket and feather duster, smiling and multitasking. On the right, her present self slumps exhausted on an orange sofa, holding a cup of tea, with droopy eyes, tangled hair, and a 5% battery icon above her head. Grey brain-fog clouds float around her. A speech bubble reads, “PEM says I pay for that walk… with interest.” A calendar marked “PACING” hangs on the wall behind them.
🧠 PEM vs PESE
Not just tired. Not lazy.
PEM = post-exertional malaise.
PESE = post-exertional symptom explosion.
Crash hours after activity. Lasts days.
Science backs it. Rest isn’t weak—it’s essential.
More on Longcovidjourney.com
#LongCovid #PESE #PEM #Pacing #LongCovidJourney #mecfs #ms #me
Still sick months after COVID?
You’re not “just tired.” It’s called Long COVID and it’s very real.
🧠 Brain fog
💥 Fatigue that worsens after activity
💓 Racing heart
😮💨 Breathlessness
Standard tests often miss it. Science doesn’t.
We explain the evidence longcovidjourney.com
#LongCOVID #PESE #POTS
Screenshot of the wikipedia definition of PEM etc as below "Post-exertional malaise (#PEM), sometimes referred to as post-exertional symptom exacerbation (#PESE) or post-exertional neuroimmune exhaustion (#PENE), is a worsening of symptoms that occurs after minimal exertion. It is the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (#MECFS) and common in #longCOVID and fibromyalgia. PEM is often severe enough to be disabling, and is triggered by ordinary activities that healthy people tolerate. Typically, it begins 12–48 hours after the activity that triggers it, and lasts for days, but this is highly variable and may persist much longer. Management of PEM is symptom-based, and patients are recommended to pace their activities to avoid triggering PEM." https://en.m.wikipedia.org/wiki/Post-exertional_malaise
"Post-exertional malaise ( #PEM), sometimes referred to as post-exertional symptom exacerbation ( #PESE) or post-exertional neuroimmune exhaustion ( #PENE), is a worsening of symptoms that occurs after minimal exertion. It is the hallmark..."
en.m.wikipedia.org/wiki/Post-ex... ... #longCovid #MECFS
Post Exertional Symptom Exacerbation #PESE or #PEM explained really well. Show you clinicians 💙
#MyalgicEncephalomyelitis
#LongCovid
#MEAwarenessMonth
youtube.com/watch?v=tcXn...
#myalgicencephalomyelitis #mecfs #MyalgicE #postexertionalmalaise #PEM #PostExertionalSymptomExacerbation #pese #PostExertionalNeuroimmuneExhaustion #PENE #ChronicFatigue #PersistantFatigue #Burnout #PostViralIllness #PostViralSyndrome
Exploring the Molecular Pathways of #LongCOVID With Post-Exertional Fatigue: A Multiomic Approach
#PEM #PESE
www.croiconference.org/abstract/180...
Sending solidarity to everyone in a flare today after ⬆️ screen & social media time for #LongCovidAwarenessDay......hello #PESE
Well done & thank you to everyone! 🫶🫂
#LongCOVID #POTS #ChronicMigraine #VestibularMigraine #Migraine #PwME #MECFS #MCAS #TeamClots #NEISVoid
